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Kneeling to Muscle Therapy 

 Many of our readers have asked for my opinion about a knee condition commonly referred to as Patellofemoral Syndrome or PTFS for short.

PTFS or Patellofemoral Syndrome is exactly that, a syndrome. In my other readings, I explain that the word "syndrome" in medicine refers to a condition that is generally not well understood and represents a series of symptoms and signs.

However, medically speaking, the translation converts to kneecap over the femur syndrome or a grinding kneecap.

In my opinion, the cause is a combination of outer quadriceps muscle weakness, due to shortening, scarring and spasm and change in nerve function of the outer or lateral quadriceps muscle.

The result being, a slightly displaced and compressed kneecap that wears along an abnormal groove. The end result of these changes is a cracking, crunching, worn out and painful knee.

Ultimately cartilage and bone degeneration develops under the kneecap and over the femur. Sometimes chondromalacia is a term used to describe the cartilage damage under the kneecap.

A recent study from Finland studied 45 patients of an average age of 27, with unilateral (one-sided) patellofemoral pain. Patients enrolled in the study were randomized into treatment groups. One group received intra-articular injections of glycosaminoglycan sulphate plus exercise, while the other group did exercise alone. The exercise suggested was quadriceps exercising (no specifics given). 

The study demonstrated no difference between the injection treatments versus exercise alone. The information also showed that good results were maintained over seven years with continuation of the exercises.

Edited from Journal Watch, May 1999, page7O, from Kannus p et al, an outcome study of chronic patellofemoral pain syndrome. J Bone Joint Surg Am 1999 Mar; 81-A; 355-63.

My opinion is clear. PTFS can usually be reversed and prevented by regimented stretching of the iliopsoas, quadriceps group, hamstring and rotational muscles of the lower spine to reverse neuropathy. I treat the leg and spine as a unit, therefore increasing chances of success. Sometimes, however, knee surgery is still required.

As always, keep long and strong.

Click Here For A Stretching Video For Arthritis of the Knee